Restorative Dentistry

Veneers and bonding

 

Porcelain Veneers

Veneers are thin pieces of porcelain bonded to the surface of your teeth, creating a durable and beautiful smile. Veneers may be the answer to correcting severely discolored, chipped, or misshapen teeth. There are two types of veneers:

  • porcelain (indirect) veneers, custom created in a dental laboratory to fit your teeth and require two visits to complete.
  • composite (direct) veneers, in which composite material is bonded to your tooth in a single visit.

With porcelain veneers, the dentist removes a small amount of the tooth surface to permit placement of the veneers. An impression is then taken of the teeth and sent to a dental laboratory, allowing the lab to create custom fit veneers for your teeth. At the second appointment, the veneers are bonded to the teeth with resin cement.

 

Composite Bonding

Bonding uses a tooth-colored composite resin to restore chipped, broken or discolored teeth. Unlike veneers which are created in a dental laboratory, bonding can be done in the dental office in a single visit. The surface of the tooth is prepared by applying an etching solution. The resin is then applied to the tooth, sculpted and shaped, hardened with a high-intensity light, and finally polished.

 

Dental Implants

Single tooth implants

Implant-supported dentures

Dental implant restoration services are available from the experienced staff of Neil W. Vanik, DDS PA for patients of all ages. Dr. Vanik has been doing the restorative work on implants for over 20 years and works closely with experienced specialists he trusts to place the implant surgically. Dental implants can be used to replace either a single tooth, multiple teeth, or to support dentures.

 

What is an implant?

A dental implant is a titanium root replacement. Like a tooth root, a dental implant is secured in the jawbone and is not visible once placed surgically. Dental implants are used to anchor the crown (the visible part of a tooth), bridgework or dentures. Titanium and titanium alloys are lightweight, strong and have great corrosion resistance, making them inert biomaterial (which means they will not change or be rejected after being implanted in the body) Titanium and titanium alloys are used in both dental and other bone implants, such as orthopedic joint replacements.

The successful osseointegration (fusion with the bone) of titanium is the biological basis of dental implant success. That’s because when teeth are lost, the bone that supported those teeth gradually erodes as well. Placing dental implants stabilizes bone, preventing its loss. Along with replacing lost teeth, implants help maintain the stability of the jawbone, support the facial skeleton and, indirectly, the soft tissue structures of gum tissues, cheeks and lips. Dental implants will help you to eat, chew, smile, and talk comfortably and naturally.

 

Implant procedure time-line for Crowns and Bridges

Once the specialist has placed your implant (or implants), 4 to 6 months are required for “osseointegration” (fusion with the bone). When the implants have successfully osseointegrated, Dr. Vanik takes an impression to begin restorative work for the crown (the visible part of the tooth). At the final appointment 2-3 weeks later, your new custom crown is ready to be attached to the implant. Other time lines apply for implant supported dentures.

As this is a brief introduction, for a more in-depth explanation, contact our office at 410-268-5046 to schedule a consultation with Dr. Vanik and find out if dental implants are a solution for you.

 

Dental Crowns

A dental crown is a tooth-shaped “cap” placed over a weak, broken or severely discolored tooth to restore its function and beauty. A crown can also be placed on top of a dental implant surgically placed by an oral surgeon. We may recommend a crown to:

  • restore a broken or discolored tooth
  • restore a tooth that has had root canal treatment
  • protect a weakened tooth from fracturing
  • replace a large filling when a tooth can no longer support a filling
  • to anchor a dental bridge in place
  • restore a dental implant

Currently, dental crowns can be made from several types of materials – listed here in order of appearance in dental history.

 

Gold

Gold crowns are among our oldest options, harking back to the Etruscans as early as 700-600 BC. While no longer the first choice typically for your front teeth, gold is an excellent material – highly durable and biocompatible (inert in the oral environment) – making it a great option for the out of sight molars that do the hard work of chewing. Because gold can be made quite thin, it fits well over smaller teeth.

 

Porcelain-metal (PFM) crowns

PFM’s can be considered a hybrid between the two other types of dental crowns, as they are porcelain fused to a metal alloy. This combines the strength of metal and the lifelike appearance of porcelain as they are color-matched to your teeth.

 

All-ceramic crowns

As you might guess, all-ceramic crowns are made entirely out of a glass-like compound. Currently, two base compounds have emerged for all-ceramic crowns: 1. Lithium Disilicate and 2. Zirconia. Each of these has its own benefits and problems.

Lithium disilicate is our most life-like crown, and has the translucent look of a tooth. It is strong and beautiful, and especially popular on front teeth. It can be used on most back tooth situations, but cannot be used to make a bridge as it will fracture. You also cannot “drill” a hole (as is commonly done for a root canal) in the crown without causing the crown to fail. There is no way to remove the crown so that the tooth under it can be worked on; if you need repairs, you need a new crown.

Zirconia is the strongest ceramic. This material can be used to make a normal span bridge without fracture. You can “drill” a hole, without condemning the crown to be made over. While Zirconia is not as life-like as lithium disilicate (the color is not as translucent as teeth), it should be noted that the materials field changes rapidly enough to hope for such improvements in the future. Another problem with Zirconia is that is has already been used in medicine for hip replacements, and has failed at 7 years. Large scale use of Zirconia is around 5 years old, so we are approaching the old failure point. (Dental Experts seem to feel that the cycling from wet to dry that occurs in the mouth will make the Zirconia last) We will see in the next 3 years. Finally, this type of crown many times cannot be repaired.

Contact our office to schedule a consult to determine the best solution for your restorative work.

 

Dental Bridges

Missing teeth can seriously impact not only the aesthetics of your smile, but also your oral health. Gaps left by missing teeth may lead to rotation or shifting of the remaining teeth into the empty spaces, resulting in a bad bite, or “malocclusion”.

 

What is a bridge?

A bridge is one way of replacing a missing tooth or teeth using either the adjacent teeth or dental implants as anchors. A bridge is a fixed device made up of: (1) two crowns or “caps” on the adjacent teeth or implants (these crowns serve as anchors for the bridge and are called “abutments”) and (2) one or more false teeth in the middle (called pontics, and are attached to the crowns that cover the abutments)

 

Materials used to make Dental Bridges

Dental bridges can be made from several types of materials – these are the most commonly used in our office.

 

Gold

Gold crowns are among our oldest options, harking back to the Etruscans as early as 700-600 BC. While no longer the first choice typically for your front teeth, gold is an excellent material – highly durable and biocompatible (inert in the oral environment) – making it a great option for the out of sight molars that do the hard work of chewing. Because gold can be made quite thin, it fits well over smaller teeth.

 

Porcelain-metal (PFM) bridges

PFM’s can be considered a hybrid between the two other types of dental bridges, as they are porcelain fused to a metal alloy. This combines the strength of metal and the lifelike appearance of porcelain as they are color-matched to your teeth.

 

All-ceramic bridges

As you might guess, all-ceramic bridges are made entirely out of a glass-like compound. Currently, two base compounds have emerged for all-ceramic crowns: 1. Lithium Disilicate and 2. Zirconia. Each of these has its own benefits and problems.

Lithium disilicate is our most life-like crown, and has the translucent look of a tooth. It is strong and beautiful, and especially popular on front teeth. It can be used on most back tooth situations, but cannot be used to make a bridge as it will fracture. You also cannot “drill” a hole (as is commonly done for a root canal) in the crown without causing the crown to fail. There is no way to remove the crown so that the tooth under it can be worked on; if you need repairs, you need a new bridge.

Zirconia is the strongest ceramic. This material can be used to make a normal span bridge without fracture. You can “drill” a hole, without condemning the crown to be made over. While Zirconia is not as life-like as lithium disilicate (the color is not as translucent as teeth), it should be noted that the materials field changes rapidly enough to hope for such improvements in the future. Another problem with Zirconia is that is has already been used in medicine for hip replacements, and has failed at 7 years. Large scale use of Zirconia is around 5 years old, so we are approaching the old failure point. (Dental Experts seem to feel that the cycling from wet to dry that occurs in the mouth will make the Zirconia last) We will see in the next 3 years. Finally, this type of bridge many times cannot be repaired.

Contact our office to schedule a consult to determine the best solution for your restorative work.

Call 410-268-5046

Hours: 8am-5pm Monday-Thursday

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Neil W. Vanik, D.D.S.
1610 McGuckian Street
Annapolis, Maryland 21401